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Global Well Being Scale

INSTRUMENT EVALUATION

A STUDY OF THE RELIABILITY, VALIDITY, AND RESPONSIVENESS OF A SELF-ADMINISTERED INSTRUMENT TO MEASURE GLOBAL WELL-BEING*

Cheryl Hawk, D.C., Ph.D., Marie Dusio, D.C., M.S.**, Harry Wallace, D.C., Terry Bernard, D.C., and Curtis Rexroth, M.A.,D.C.

An Investigation Conducted at the Institute of Research and Graduate Studies, Palmer College of Chiropractic – Davenport, Iowa.

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ABSTRACT

In order to substantiate the effects of chiropractic care, appropriate outcome measures must be available.  Patient-centered instruments are gaining credibility for demonstrating the effects on general health status and well-being.  Although a number of questionnaires are in use, there appears to be a need for an instrument measuring an immediate sense of general well-being, that can be administered quickly and scored easily.  The purpose of this study is to develop such an instrument and to test it for reliability, validity, and responsiveness to clinical changes.  This instrument, the Global Well-Being Scale (GWBS), is a version of a Visual Analog Scale (VAS).  Intraclass  correlation coefficient was used to assess reliability.  To assess construct validity, the GWBS was compared to the RAND-36 Health Status Survey and to a VAS for pain, using the Pearson product moment correlation.  Responsiveness to clinical change was assessed in twenty-six symptomatic patients by its administration before and immediately after a chiropractic adjustment.  The intraclass correlation coefficient was 0.93.  The GHWBS was significantly correlated to the emotional well-being and energy subscales of the RAND-36 in a non-patient population, but no statistically significant correlations were observed in the group of twenty-six patients.  The GWBS was not significantly correlated with the VAS for pain.  The effect size of the pre-to-post-change (0.91) was considered large.  The results of this initial study indicate that the instrument may be useful to clinicians as a supplement to other measures, particularly in assessing post-adjustment response to treatment in terms of general state of well-being.  Further study is needed to better characterize the quality of qualities this instrument measures.  Combined with other measures, it may have utility in monitoring treatment plans and in assessing possible placebo effects.

KEYWORDS:  (MESH) HEALTH STATUS, REPRODUCIBILITY OF RESULTS, CHIROPRACTIC, HEALTH STATUS INDICATORS, QUESTIONNAIRES.

*Submitted for publication:  21 September 1994.  The use of human subjects in this research was reviewed and approved by the Institutional Review Board of Palmer College of Chiropractic.

**Reprint requests:         Dr. Cheryl Hawk,

                                                        Institute of Graduate Studies and Research

                                                        Palmer College of Chiropractic

                                                        741 – North Brady Street

                                                        Davenport, Iowa  52803

Palmer Journal of Research 2(1):15-22

© 1995 ISSN 1076-478X                                 For the entire article click here!